Shantae Alicia Fyffe-Simpson

Primary specialty

Social WorkerTaxonomy code 104100000X

License

6889 Issued in CT

Practice address

101 Head of Meadow Rd
Newtown, CT 06470-1788

Phone

(917) 543-4521

NPI assigned

Oct 21, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Shantae Alicia Fyffe Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Interoperability endpoints

• Direct secure messaging: shantae.fyffesimpson.p1@direct.wheelerclinic.nextgenshare.com

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1571616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1841833159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 HEAD OF MEADOW RD",
            "city": "NEWTOWN",
            "state": "CT",
            "postal_code": "064701788",
            "telephone_number": "917-543-4521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 HEAD OF MEADOW RD",
            "city": "NEWTOWN",
            "state": "CT",
            "postal_code": "064701788",
            "telephone_number": "917-543-4521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FYFFE-SIMPSON",
        "first_name": "SHANTAE",
        "middle_name": "ALICIA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-21",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CT",
            "license": "6889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANTAE",
            "last_name": "FYFFE",
            "middle_name": "ALICIA",
            "prefix": "MRS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Francis J Forno Jr., D.O.
• Francis J Forno Jr DO, LLC
• Richard John Frankonis Sr., RPH
• Maria Freeman, MS, OTR/L, CLC
• Jeffrey P Friedman, MD
• Beth Gantert, CCC-SLP
• Garner Correctional Institution
• Elsa B George, DDS
• Kara Gerace, LCSW
• Mark J. Gerace, P.T.

• Social Worker in Newtown, CT
• Providers in Newtown, CT by specialty
• Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.